[Tyrosine kinase inhibiting the VEGF pathway and elderly people: Tolerance, pre-treatment assessment and side effects management]

Bull Cancer. 2016 Mar;103(3):259-72. doi: 10.1016/j.bulcan.2015.10.020. Epub 2016 Jan 29.
[Article in French]

Abstract

Angiogenesis inhibition is a major antitumor strategy that has emerged during the last decade. Oral tyrosine kinase inhibitors (TKI) targeting the VEGF receptor, including sunitinib, sorafenib, axitinib, regorafenib, pazopanib, and vandetanib reduce tumor growth and metastasis. These agents are approved for the treatment of metastatic diseases in first or second-line. They display a narrow therapeutic index. However, data in the elderly and/or in patients with multiple illnesses remain scarce. This population is classically excluded from clinical trials. The aim of this review is to provide an overview of existing literature regarding antiangiogenic TKI tolerance in the elderly (>70 years old). We also highlight key points of the pre-therapeutic evaluation and summarize the management of common toxicities.

Keywords: Angiogenesis; Angiogenèse; Elderly people; Inhibiteur VEGF; Sujets âgés; Toxicity; Toxicité; VEGF inhibitor.

Publication types

  • Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Angiogenesis Inhibitors / adverse effects*
  • Axitinib
  • Fatigue / chemically induced
  • Humans
  • Imidazoles / adverse effects
  • Indazoles / adverse effects
  • Indoles / adverse effects
  • Kidney / drug effects
  • Neovascularization, Pathologic / drug therapy*
  • Niacinamide / adverse effects
  • Niacinamide / analogs & derivatives
  • Phenylurea Compounds / adverse effects
  • Piperidines / adverse effects
  • Protein Kinase Inhibitors / adverse effects*
  • Pyridines / adverse effects
  • Pyrroles / adverse effects
  • Quinazolines / adverse effects
  • Receptors, Vascular Endothelial Growth Factor / antagonists & inhibitors*
  • Sorafenib
  • Sunitinib

Substances

  • Angiogenesis Inhibitors
  • Imidazoles
  • Indazoles
  • Indoles
  • Phenylurea Compounds
  • Piperidines
  • Protein Kinase Inhibitors
  • Pyridines
  • Pyrroles
  • Quinazolines
  • regorafenib
  • Niacinamide
  • Sorafenib
  • Axitinib
  • Receptors, Vascular Endothelial Growth Factor
  • Sunitinib
  • vandetanib